scholarly journals Haemorrhoidal haemodynamic changes in patients with haemorrhoids treated using Doppler-guided dearterialization

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
A Parello ◽  
F Litta ◽  
V De Simone ◽  
P Campennì ◽  
R Orefice ◽  
...  

Abstract Background Arterial hyperflow to haemorrhoids has been implicated as a possible pathophysiological co-factor in haemorrhoidal disease. The purpose of this study was to investigate how transanal haemorrhoidal dearterialization (THD) can influence haemodynamic parameters at the level of the haemorrhoidal piles. Methods Patients with grade III haemorrhoids selected for THD between July and December 2018 were evaluated using endoanal ultrasonography and colour Doppler imaging at the level of internal haemorrhoids before and 1 year after the surgical procedure. Peak systolic velocity, pulsatility index, resistivity index, acceleration time, and end-diastolic velocity were measured, and preoperative and postoperative values compared. Symptom severity was measured using a symptom-based questionnaire (score range 0–20). Results Of 21 patients treated, 17 completed the study. Compared with preoperative values, postoperative peak systolic velocity (mean(s.d.) 18.7(1.1) versus 10.3(0.4) cm/s; P < 0.05), pulsatility index (5.5(0.3) versus 2.8(0.4); P < 0.050), and resistivity index (1.0(0.2) versus 0.8(0.5); P < 0.050) decreased significantly, whereas acceleration time increased significantly (65.6(3.6) versus 83.3(4.7) cm/s2; P < 0.050); end-diastolic velocity did not change (1.9(0.2) versus 2.0(0.4); P = 0.753). Symptoms disappeared or had improved significantly in all patients by 1 year after surgery. The mean(s.d.) total symptom severity score decreased from 15.8(1.1) to 1.2(1.6) (P < 0.001). Conclusion THD affects the main haemodynamic parameters at the level of internal haemorrhoids and is associated with a decrease in arterial hyperflow.

2018 ◽  
Vol 46 (1) ◽  
pp. 5
Author(s):  
Ivan Felismino Charas Dos Santos ◽  
Letícia Rocha Inamassu ◽  
Sheila Canevese Rahal ◽  
Maria Jaqueline Mamprim ◽  
David José De Castro Martins ◽  
...  

Background: In Veterinary Medicine, there are several methods for early and accurate assessment of blood flow dynamics. The Dopplerfluxometry can access the peak systolic velocity, mean velocity and end diastolic velocity, including Resistive Index and Pulsatility Index. Normal values of Dopplerfluxometry in healthy dogs allow the identification of vascular abnormalities and authors’ knowledge there are no reference regarding the values of Dopplerfluxometry of the femoral artery in healthy dogs. The aim of the study was to assess the femoral Dopplerfluxometry of adult healthy dogs by Resistive Index, Pulsatility Index, systolic and diastolic velocities, and femoral artery diameter.Materials, Methods & Results: Eighteen healthy intact beagle dogs, male and female, aging from 2 to 4 years old (mean ± SD: mean 3 ± 0.8 years), weighing from 10.1-17.9 kg [22.3-39.5 lb] [mean ± SD: 14.3 ± 2.7 kg (31.5 ± 5.96 lb)] were used. The dogs underwent to physical examination, complete blood cell count, serum biochemistry examination urinalysis, and radiographs examination, muscular and cardiac evaluation. Females had to be in anestrous. All dogs were submitted to right femoral artery Dopplerfluxometry. The dogs were positioned in dorsal recumbency by one person without any chemical restraint. A high definition ultrasound device equipped with a 3 - 13 MHz multi-frequency linear transducer was used. The right femoral artery was identified with the transducer positioned transversely on the right triangle femoral area. Peak systolic velocity, end-diastolic velocity was measured. The Resistivity Index and Pulsatility Index were calculated automatically by the ultrasound machine software. Three measurements were obtained with the Doppler spectrum. The values of peak systolic velocity, end-diastolic velocity, Resistivity Index, Pulsatility Index and femoral artery diameter were expressed as Mean ± Standard Deviation (SD).Discussion: No studies regarding to femoral artery Dopplerfluxometry in healthy dogs were found in the literature. These results can be used as normal reference values of Dopplerfluxometric parameters for adult dogs. The literature cited only Dopplerfluxometric values of renal arteries, abdominal aorta and of the internal thoracic artery. The normal values of arterial Dopplerfluxometry is necessary to identify the spectral quantitative characteristics of the blood flow for diagnosis and prognosis of vascular diseases. Authors referred to changes in blood perfusion by Dopplerfluxometry examination, but no changes in B-mode ultrasonography. The femoral Resistivity Index values can be used to correlate the postoperative evolution in dogs submitted to femoral bone, hip and knee surgeries, since Dopplerfluxometry allows blood flow assessment in the femoral region muscles. Changes in the heart rate, blood pressure, stress, exercise, and diseases as hypotension, renal lesion, hepatic diseases, diabetes, hyperadrenocorticism can change the Dopplerfluxometric parameters. All dogs which used in this study were clinically healthy, and were used beagle dogs due to lowest variations within breed. Sedation was avoid due to possible changes in Dopplerfluxometric parameters since the use of sedation or tranquilization in animals is strongly discussed due to possible hemodynamic changes that may occur during the examination. In conclusion, the mean values of the right femoral artery Dopplerfluxometry in male and female adult healthy dogs is Resistivity Index (0.887); Pulsatility Index (1.599); peak systolic velocity (124.41 cm/s), end-diastolic velocity (14.12 cm/s), femoral artery diameter (3.9 mm).


BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200003
Author(s):  
Vincent W.C. Wu ◽  
Michael TC Ying ◽  
Dora LW Kwong ◽  
Pek-Lan Khong ◽  
Gary KW Wong ◽  
...  

Objectives: With regard to the intensity modulated radiotherapy (IMRT) of nasopharyngeal carcinoma (NPC) patients, this longitudinal study evaluated the radiation-induced changes in the parotid and submandibular glands in terms of gland size, echogenicity and haemodynamic parameters. Methods: 21 NPC patients treated by IMRT underwent MRI and ultrasound scans before radiotherapy, and at 6, 12, 18 and 24 months after treatment. Parotid and submandibular gland volumes were measured from the MRI images, whereas the parotid echogenicity and haemodynamic parameters including the resistive index, pulsatility index, peak systolic velocity and end diastolic velocity were evaluated by ultrasonography. Trend lines were plotted to show the pattern of changes. The correlations of gland doses and the post-RT changes were also studied. Results: The volume of the parotid and submandibular glands demonstrated a significant drop from pre-RT to 6 months post-RT. The parotid gland changed from hyperechoic before RT to either isoechoic or hypoechoic after treatment. The resistive index and pulsatility index decreased from pre-RT to 6 month post-RT, then started to increase at 12 month time interval. Both peak systolic velocity and end diastolic velocity increased after 6 months post-RT then followed a decreasing trend up to 24 months post-RT. There was mild correlation between post-RT gland dose and gland volume, but not with haemodynamic changes. Conclusions: Radiation from IMRT caused shrinkage of parotid and submandibular glands in NPC patients. It also changed the echogenicity and vascular condition of the parotid gland. The most significant changes were observed at 6 months after radiotherapy. Advances in knowledge: It is the first paper that reports on the longitudinal changes of salivary gland volume, echogenicity and haemodynamic parameters altogether in NPC patients after radiotherapy. The results are useful for the prediction of glandular changes that is associated with xerostomia, which help to provide timely management of the complication when the patients attend follow-up visits.


2020 ◽  
Vol 48 (5) ◽  
pp. 504-508
Author(s):  
Ya Tan ◽  
Shi Zeng ◽  
YuShan Liu ◽  
HuaYu Tang ◽  
BaiHua Zhao

AbstractObjectiveTo observe Doppler ultrasound changes in the two segments of the posterior cerebral artery (PCA) in fetuses with transposition of the great arteries (TGA).MethodsThe peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and velocity-time integral (VTI) of the two segments of PCA (the first segment: PCAS1, the second segment: PCAS2) and of the middle cerebral artery (MCA) were compared in TGA fetuses and normal fetuses. The abnormality rate between the PCAS1-PI and MCA-PI was compared in TGA fetuses.ResultsThe PCAS1-PI and MCA-PI were smaller in the TGA fetuses than in the controls (all P < 0.05), but the PCAS2-PI was unchanged (P > 0.05). The MCA-VTI, PCAS1-VTI, and PCAS2-VTI were larger in the TGA fetuses (all P < 0.05). In the TGA fetuses, the abnormality rate of the PCAS1-PI was significantly higher than that of the MCA-PI (P < 0.05).ConclusionIn fetuses with TGA, there were hemodynamic differences between the two segments of the posterior cerebral arteries. Moreover, PCAS1 exhibited signs of vasodilatation more obviously than did the MCA in fetuses with TGA.


Author(s):  
Andrej Udelnow ◽  
Maria Hawemann ◽  
Ivo Buschmann ◽  
Frank Meyer ◽  
Zuhir Halloul

Summary Background Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements. Methods A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities). Results In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree. Conclusion Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.


2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 137-138
Author(s):  
Allison M Meyer ◽  
Natalie B Duncan ◽  
Katy S Stoecklein ◽  
Emma L Stephenson

Abstract To determine parity effects on late gestational uteroplacental blood flow, uterine artery hemodynamics were measured in 13 primiparous and 11 multiparous (parity 3 and 4) non-lactating, fall-calving crossbred females beginning 109 d prepartum. Females were nutritionally managed as one group to meet or exceed nutrient requirements. Transrectal color Doppler ultrasonography of the both uterine arteries was conducted 3 to 6 times per female across late gestation, ending at approximately 20 d prepartum. Data were analyzed with parity (primiparous vs. multiparous), day prior to calving, and their interaction in the model; day was a repeated effect. Dam BW was greater (P &lt; 0.001) for multiparous than primiparous females, and increased (P = 0.004) as gestation progressed. Calf birth weight was unaffected (P = 0.87) by parity. The parity x day interaction tended to affect (P = 0.06) ipsilateral uterine artery blood flow (L/min), where multiparous cows had a greater increase per day. Total and contralateral uterine artery blood flow were unaffected (P ≥ 0.11) by parity, but increased (P &lt; 0.001) with day of gestation. When expressed relative to dam BW, total and contralateral blood flow were greater (P ≤ 0.04) in primiparous than multiparous females; ipsilateral blood flow was unaffected (P ≥ 0.13) by parity, however. Ipsilateral pulsatility index and both resistance indices were unaffected (P ≥ 0.28) by parity and day, but day tended to affect (P = 0.07) contralateral pulsatility index. Parity did not affect (P ≥ 0.11) cross-sectional area, mean velocity, peak systolic velocity, and end diastolic velocity of either uterine artery, but all increased (P &lt; 0.001) as gestation progressed. Heart rate was greater (P = 0.03) in primiparous than multiparous females. Data suggest that uterine artery blood flow and heart rate may be altered in primiparous females, even when birth weight is unaffected by parity.


2013 ◽  
Vol 5 (2) ◽  
pp. 147-153 ◽  
Author(s):  
S Sood ◽  
Subina Narang ◽  
S Kocchhar ◽  
S Sarda ◽  
S Aggarwal ◽  
...  

Introduction: Color Doppler Imaging (CDI) is used widely to study retrobulbar circulation. Objectives: To determine the association between progression of diabetic retinopathy (DR) and alterations in retrobulbar arterial circulation using CDI studies. Materials and methods: Prospective observational case series. It is single institutional study of 50eyes of nonproliferative diabetic retinopathy in 50 patients with type II diabetes mellitus. DR was graded according to ETDRS system. Retrobulbar circulation was studied in patients for Peak systolic velocity (PSV), End diastolic velocity (EDV) and Resistive index (RI) in Central retinal artery (CRA), Ophthalmic artery (OA) and Posterior ciliary artery (PCA) using CDI initially and reevaluated after 6 months or later for any change in retinopathy grade and arterial circulation parameters. The patients were grouped as Group I not showing progression of DR and Group II showing progression. The two groups were compared for any significant change in CDI parameters. Results: The baseline resistive indices were higher than normal population. There was significant increase in RI in PCA and CRA in all patients after 6 months. 14 patients (28%) showed progression of DR and 36 (72%) did not show progression of DR. There was no significant association with progression of retinopathy and CDI findings. (p=>0.05). Conclusion: The retrobulbar arterial circulation seems to be affected in all diabetics with DR. The changes appear to be progressive. The CDI findings in arterial circulation however lack predictive power for progression of diabetic retinopathy in non proliferative DR. Nepal J Ophthalmol 2013; 5(10): 147-153 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8705


2011 ◽  
Vol 22 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Ivan Marjanovic ◽  
Natasa Milic ◽  
Antonio Martinez

Purpose To assess the retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCA) after decreasing elevated intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) by using color Doppler imaging. Methods A total of 46 eyes from 46 patients with OAG, with elevated IOP, were consecutively included in this prospective study. Peak-systolic velocity, end-diastolic velocity, and Pourcelot resistivity index were assessed in the OA, CRA, and PCA. The IOP was measured with Goldmann applanation tonometer (GAT) and the dynamic contour tonometer (DCT), 3 times respectively. Ocular pulse amplitude (OPA) appeared during the DCT measurement. Results After decreasing the elevated IOP, measured with both GAT and DCT, the retrobulbar parameters showed no differences as compared with baseline measurements. After Bonferroni correction (p≤0.0042, alpha/12), statistical significance appeared in retrobulbar hemodynamics only in DCT (29.3±6.4 vs 15.5±4.2 mmHg), GAT (33.0±8.3 vs 15.8±7.0 mmHg), and OPA measurements (4.1±1.3 vs 2.7±1.4 mmHg), in comparison to baseline. There was no correlation between the changes in IOP measured with either DCT or GAT and the changes in the retrobulbar hemodynamic parameters (p>0.05 for all). Conclusions The results of our study suggested a lack of correlation between the changes in IOP, measured with either DCT or GAT, and the changes in the retrobulbar hemodynamic parameters. The results of our study might suggest that the blood flow disturbances found in glaucoma patients are independent of the IOP.


2020 ◽  
Vol 189 (4) ◽  
pp. 1259-1265 ◽  
Author(s):  
Aleksandra Paduszyńska ◽  
Agata Sakowicz ◽  
Maciej Banach ◽  
Marek Maciejewski ◽  
Marek Dąbrowa ◽  
...  

Abstract Background Adipose tissue is producing adipokines that play different roles in the pathophysiology of cardiovascular disease. Aims The study aimed to assess the role of selected biomarkers in hypertensive patients with overweight and obesity compared with those with normal body-mass index (BMI). Methods A total of 62 patients with BMI < 25 kg/m2 (median age 54 (46–58) yrs., 57% males) and 51 with BMI ≥ 25 kg/m2 (median age 53 (48–59) yrs., 37% males) were enrolled. Biochemical parameters, leptin, adiponectin, and resistin; asymmetric dimethylarginine; interleukin 6; and N-terminal propeptide of type III procollagen, were assessed in plasma. The evaluation of hemodynamic parameters was performed using SphygmoCor 9.0 tonometer. Echocardiography was performed using AlokaAlpha 10 Premier device. Results Overweight and obese patients had significantly higher concentration of leptin (34 vs 18 ng/ml; p = 0.03), ADMA (0.43 vs 0.38 μmol/l, p = 0.04), and lower concentration of adiponectin (5.3 vs 7 μg/ml, p = 0.01). The only significant difference in tonometry analysis was higher aortic pulse pressure (mmHg) in patients with BMI ≥ 25 kg/m2 group (34 vs 30; p = 0.03). These patients had also significantly lower peak systolic velocity and early diastolic velocity in tissue Doppler imaging of the right ventricle free wall at the level of the tricuspid annulus compared with controls (p = 0.02 and p = 0.001, respectively). The level of leptin is correlated negatively with the left ventricular mass index (LVMI) (R Spearman = − 0.5; p = 0.002) and PWV (R = − 0.4; p = 0.01) and ADMA with total and LDL cholesterol (R = − 0.42; p = 0.008), and adiponectin is correlated positively with HDL cholesterol (R = 0.67; p = 0.0001). Conclusions Leptin concentrations were inversely proportional to LVMI and PWV in patients with BMI < 25 kg/m2. Trial registration Clinicaltrials.gov study ID: NCT04175080.


2014 ◽  
Vol 71 (12) ◽  
pp. 1128-1131 ◽  
Author(s):  
Ivan Marjanovic ◽  
Marija Marjanovic ◽  
Ranko Gvozdenovic ◽  
Dusica Risovic

Background/Aim. Several factors may have influence on systemic circulation. Additionally, peripheral circulation also demonstrates sex differences, in young women presenting significantly lower finger blood flow in comparison to men of the same age, a finding that disappears in women after menopause. The aim of this study was to compare the retrobulbar hemodynamic parameters measured by means of color Doppler imaging in women and men with open-angle glaucoma and elevated intraocular pressure. Methods. A total of 52 eyes from 52 open-angle glaucoma (OAG) patients, with elevated intraocular pressure (IOP), were included in this cross-sectional study. Peak-systolic velocity (PSV), end-diastolic velocity (EDV), and Pourcelot resistivity index (RI) were assessed in the ophtalmic artery (OA), central retinal artery (CRA), and posterior cilliary arteries (PCA). IOP was measured both with Goldmann Applanation tonometer (GAT) and with the dynamic contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) appeared during the DCT measurement. Results. The retrobulbar hemodynamic parameters did not show any difference between men and post-menopausal women. Conclusion. The results of our study did not find any difference between sexes in patients with open-angle glaucoma and elevated intraocular pressure.


2016 ◽  
Vol 1 (2) ◽  
pp. 59-69
Author(s):  
Lucia Carichino ◽  
Giovanna Guidoboni ◽  
Alice Chandra Verticchio Vercellin ◽  
Giovanni Milano ◽  
Carlo Alberto Cutolo ◽  
...  

Purpose: Arterial waveform parameters (WPs) are commonly used to monitor and diagnose systemic diseases. Color Doppler Imaging (CDI) is a consolidated technique to measure blood velocity profile in some of the major ocular vessels. This study proposes a computer-aided manipulation process of ophthalmic artery (OA) CDI images to classify and quantify WPs that might be significant in the assessment of glaucoma.Methods: Fifty CDI images acquired by four different operators on nine healthy individuals and 38 CDI images of 38 open-angle glaucoma (OAG) patients were considered. An ad-hoc semi-automated image processing code was implemented to detect the digitalized OA velocity waveform and to extract the WPs. Concordance correlation coefficient (CCC), two-sample t-test and Pearson’s correlation coefficient were used to test for similarities, differences and associations among variables.Results: The OA-CDI images manipulation proposed showed a higher concordance between measured peak systolic velocity (PSV) data and extracted PSV data (0.80≤CCC≤0.98) than on end diastolic velocity (EDV) (0.45≤CCC≤0.63) and resistive index (RI) (0.30≤CCC≤0.58) data. In OAG patients, EDV, RI, subendocardial viability ratio (SEVR), period (T), area ratio (f) and normalized distance between ascending and descending limb (DAD/T) were found statistically correlated to at least one of the following factors: gender, age, ocular medications and year of diagnosis. When compared to healthy individuals, OAG patients OA-CDI profiles showed statistically higher values of f (p < 0.001) and DAD/T (p = 0.002) (p-values corrected by age and gender).Conclusion: The proposed computer-aided manipulation of OA-CDI images allowed to identify DAD/T as a novel WP that vary significantly among healthy individuals and OAG patients, and among female and male OAG patients. Future studies on longitudinal OAG data are suggested to investigate the potential of DAD/T to predict severity and progression of the disease.


Sign in / Sign up

Export Citation Format

Share Document